Surgical instrument with jaws and movable internal scissors and method for use thereof

Abstract

A surgical instrument includes a forceps unit for being positioned within an anatomical cavity and inner member having scissors at a distal end thereof. The forceps unit includes a housing, an outer tubular member, an intermediate member, and a handle mechanism coupled with at least one of the intermediate and outer tubular members for creating relative movement between the intermediate and outer tubular members. The outer tubular member has a proximal end mounted on the housing and terminates distally at a distal end. The intermediate member has a tubular body disposed telescopically within the outer tubular member, a proximal end mounted in the housing and an integral one-piece distal end defining a pair of opposed jaws resiliently biased apart such that relative movement of the outer tubular member distal end over the jaws causes the jaws to close. The inner member includes a tubular member removably disposed at least partly within the intermediate member and carrying scissors for performing at least one of the functions of cutting, cauterizing, or the like. The scissors can be selectively advanced to be between the jaws for cutting by closing the jaws.

What is claimed is: 
     
       1. A surgical instrument comprising a tubular outer member having a proximal end and terminating distally at a distal end;   an intermediate member having a tubular body disposed telescopically within said outer member, a proximal end and a distal end defining a pair of opposed jaws resiliently biased apart;   an inner member comprising a shaft and scissor blades at a distal end of said shaft, said inner member being slidably disposed at least partly within said intermediate member;   a handle coupled with at least one of said intermediate and outer tubular members and configured to move said pair of opposed jaws move between open and closed positions.   
     
     
       2. An instrument as recited in claim 1 wherein said jaws define opposed grasping surfaces. 
     
     
       3. An instrument as recited in claim 2 wherein a longitudinal groove is formed in one of said grasping surfaces. 
     
     
       4. An instrument as recited in claim 3 wherein said longitudinal groove extends part way along said one of said grasping surfaces to define a stop limiting distal movement of said scissor blades advanced along said groove. 
     
     
       5. An instrument as recited in claim 3 wherein said longitudinal groove extends along an entire length of said one of said grasping surfaces. 
     
     
       6. An instrument as recited in claim 2 wherein a longitudinal groove is formed in each of said grasping surfaces. 
     
     
       7. An instrument as recited in claim 6 wherein said longitudinal grooves extend part way along said grasping surfaces to define a pair of stops limiting distal movement of said scissor blades advanced along said grooves. 
     
     
       8. An instrument as recited in claim 6 wherein said longitudinal grooves extend along entire lengths of said grasping surfaces. 
     
     
       9. An instrument as recited in claim 1, further comprising cam members disposed on outer surfaces of said jaws. 
     
     
       10. An instrument as recited in claim 1 wherein said jaws include opposed arcuate portions defining an opening between said jaws. 
     
     
       11. An instrument as recited in claim 1 wherein one of said jaws is fixed parallel to a longitudinal axis of said intermediate member and the other of said jaws is movable. 
     
     
       12. An instrument as recited in claim 1 wherein said scissor blades comprise a pair of pivoted cutting blades with opposed cutting edges. 
     
     
       13. An instrument as recited in claim 12 wherein one of said pivoted cutting blades is fixed to extend longitudinally and the other of said pivoted blades is movable. 
     
     
       14. An instrument as recited in claim 12 wherein both of said pivoted cutting blades are movable. 
     
     
       15. An instrument as recited in claim 1 wherein said scissor blades are integrally formed with said shaft. 
     
     
       16. An instrument as recited in claim 1 wherein a pair of opposed grooves are formed in said jaws and said scissor blades are biased apart to fit within said grooves when said inner member is advanced to place said scissor blades between said jaws. 
     
     
       17. An instrument as recited in claim 1 wherein sail inner member is biased proximally relative to said intermediate member, said instrument further comprising a handle mounted on said inner member for being advanced distally. 
     
     
       18. An instrument as recited in claim 17 further comprising; safety means for locking said inner member to prevent movement of said inner member relative to said intermediate member.   
     
     
       19. An instrument as recited in claim 1 wherein said inner member includes valve means at a proximal end for controlling passage through said inner member. 
     
     
       20. A method of performing surgical procedures comprising the steps of introducing a tubular member with jaws through an opening in an anatomical cavity wall;   advancing an inner member having scissor blades distally through the tubular member so that said scissor blades are between said jaws; and   performing a cutting procedure with said scissor blades.   
     
     
       21. A method as recited in claim 20, further comprising before said advancing step, grasping and manipulating tissue with said jaws.   
     
     
       22. A method as recited in claim 21 wherein said introducing step includes closing said jaws by sliding an outer tubular member over the jaws. 
     
     
       23. A method as recited in claim 22 wherein said grasping step includes sliding said outer tubular member proximally with respect to said jaws to permit said jaws to resiliently separate, positioning the anatomical tissue between said jaws and sliding said outer tubular member distally towards said jaws to close said jaws around the anatomical tissue. 
     
     
       24. A surgical instrument comprising a tubular outer member having a proximal end and terminating distally at a distal end, a channel being defined through said outer member;   an intermediate member having a body disposed at least partly within said outer member, a proximal end and a distal end defining a pair of opposed jaws resiliently biased apart;   an inner member comprising a shaft and scissor blades at a distal end of said shaft, said inner member being slidably disposed at least partly within said channel;   a handle means coupled with at least one of said jaws and configured to move said jaws between open and closed positions.   
     
     
       25. An instrument as recited in claim 24 wherein said channel passes through said intermediate member.